Managing Atrial Fibrillation: How Risk Factors Play a Key Role in Treatment

By Ashish Bhimani, MD
Heart Rhythm Specialist, Piedmont Heart Institute

Hello, my name is Ashish Bhimani, and I’m a physician at the Piedmont Heart Institute specializing in heart rhythm disorders. Today, I want to talk about a topic that is becoming more prevalent: atrial fibrillation (AFib) and how managing risk factors can prevent or even reverse its progression.

Understanding Atrial Fibrillation

Atrial fibrillation is generally a chronic and progressive heart condition. Over time, AFib episodes become more frequent and last longer. What’s important to note is that although treatments, such as medications or procedures, are often necessary, modifying certain risk factors can be an effective way to slow down or even stop this progression.

Watch this full video with Dr. Bhimani on What is Atrial fibrillation.

The Progression of Atrial Fibrillation

AFib episodes start small, often lasting just a few minutes before going away on their own. However, over time, these episodes can become more frequent and last longer. When the episodes are short and self-resolving, we refer to this as paroxysmal AFib. When they last more than seven days, it is classified as persistent AFib, which can eventually develop into a permanent or chronic state.

The good news? One of our treatment goals is to prevent or reverse this progression, and risk factor management plays a critical role in achieving this.

Modifiable Risk Factors for AFib

The key modifiable risk factors for atrial fibrillation include:

• Unhealthy body weight
• Sedentary lifestyle
• Alcohol use
• High blood pressure
• Diabetes
• Sleep apnea

For those who are overweight, weight loss is often the most effective strategy for preventing or reversing the progression of AFib.

Weight Loss and AFib: The Impact

Research has shown the profound effect of weight loss on AFib. In a study, patients with AFib and a Body Mass Index (BMI) over 27 were treated with AFib therapies and placed on weight management strategies. The results were striking:

• Of those who did not lose any weight, only 4 out of 10 were able to maintain normal heart rhythm after four years, while 6 went back into AFib.
• In the group that lost between 3% and 9% of their weight, 7 out of 10 were able to maintain normal rhythm.
• Those who lost more than 10% of their weight had the best outcomes—9 out of 10 patients stayed in normal rhythm.

Clearly, a 10% weight loss goal can have a significant impact on reducing AFib episodes.

The Role of Exercise

Exercise is another critical component of managing AFib risk factors. For those who are currently inactive, starting with simple activities like walking or lifting light weights can be effective. Aim for a consistent routine, exercising 3 to 5 days a week, with a mix of aerobic and strength training. The goal should be to work up to 60 to 200 minutes of exercise per week, which can reduce the overall burden of AFib.

Alcohol and AFib

Alcohol can also be a major trigger for AFib. Some individuals may experience episodes after just 1 or 2 drinks, while for others, more substantial drinking—about 7 to 10 drinks per week—can increase their risk. In one study, patients who reduced their alcohol consumption from ten drinks a week to two experienced a significant drop in AFib episodes, with only 53% having another episode within six months, compared to 73% in the group that continued drinking.

Other Risk Factors: Hypertension, Diabetes, and Sleep Apnea

While weight, exercise, and alcohol are major factors, addressing high blood pressure, diabetes, and sleep apnea also plays a vital role in AFib management. A comprehensive approach that includes treating these conditions, along with modifying other lifestyle factors, can significantly improve outcomes.

A Comprehensive Approach to AFib

At Piedmont Heart Institute we strive to make a positive difference in every life we touch, and we are committed to helping you manage your AFib with a comprehensive approach. If you or a loved one is struggling with AFib, remember that risk factor modification is a powerful tool in preventing or reversing this condition. We have providers delivering quality care across the state, so don’t hesitate to contact us for more information.

For details or to schedule an appointment, visit our website or give us a call today by calling our offices at 404-605-2888 or visit our website piedmont.org/afib.

This post provides a comprehensive overview of how AFib patients can manage their condition by focusing on modifiable risk factors, backed by data-driven insights into the benefits of lifestyle changes.